Provider Demographics
NPI:1902839426
Name:NHAN XUAN NGUYEN,M.D. INC.
Entity Type:Organization
Organization Name:NHAN XUAN NGUYEN,M.D. INC.
Other - Org Name:NHAN X. NGUYEN,M.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NHAN
Authorized Official - Middle Name:X
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-537-8269
Mailing Address - Street 1:10298 WESTMINSTER AVE
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-4830
Mailing Address - Country:US
Mailing Address - Phone:714-537-8269
Mailing Address - Fax:714-537-8065
Practice Address - Street 1:10298 WESTMINSTER AVE
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-4830
Practice Address - Country:US
Practice Address - Phone:714-537-8269
Practice Address - Fax:714-537-8065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA50424207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A504240Medicaid
CAW21702Medicare PIN